| |
1689 W Morton Ave, Jacksonville, IL 62650-2717 | |
(217) 243-6506 | |
(217) 243-4902 |
Full Name | |
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Type | Facility |
Speciality | Durable Medical Equipment & Medical Supplies |
Location | 1689 W Morton Ave, Jacksonville, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295774859 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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8309 N Knoxville Ave, Peoria, IL 61615-2170 Ph: (309) 693-9540 | 1689 W Morton Ave, Jacksonville, IL 62650-2717 Ph: (217) 243-6506 |